Objective: To evaluate the early effectiveness of navigation-free robot-assisted total knee arthroplasty (TKA) compared to traditional TKA in the treatment of knee osteoarthritis combined with extra-articular deformities.
Methods: The clinical data of 30 patients with knee osteoarthritis combined with extra-articular deformities who met the selection criteria between June 2019 and January 2024 were retrospectively analyzed. Fifteen patients underwent CORI navigation-free robot-assisted TKA and intra-articular osteotomy (robot group) and 15 patients underwent traditional TKA and intra-articular osteotomy (traditional group). There was no significant difference in age, gender, body mass index, affected knee side, extra-articular deformity angle, deformity position, deformity type, and preoperative knee range of motion, American Knee Society (KSS) knee score and KSS function score, and lower limb alignment deviation between the two groups ( P>0.05). The operation time, intraoperative blood loss, and complications of the two groups were recorded and compared. The knee range of motion and lower limb alignment deviation were recorded before operation and at 6 months after operation, and the knee joint function was evaluated by KSS knee score and function score.
Results: There was no significant difference in operation time between the two groups ( P>0.05); the intraoperative blood loss in the robot group was significantly less than that in the traditional group ( P<0.05). Patients in both groups were followed up 6-12 months, with an average of 8.7 months. The incisions of all patients healed well, and there was no postoperative complication such as thrombosis or infection. At 6 months after operation, X-ray examination showed that the position of the prosthesis was good in both groups, and there was no loosening or dislocation of the prosthesis. The knee joint range of motion, the lower limb alignment deviation, and the KSS knee score and KSS function score significantly improved in both groups ( P<0.05) compared to preoperative ones. The changes of lower limb alignment deviation and KSS function score between pre- and post-operation in the robot group were significantly better than those in the traditional group ( P<0.05), while the changes of other indicators between pre- and post-operation in the two groups were not significant ( P>0.05).
Conclusion: Compared to traditional TKA, navigation-free robot-assisted TKA for knee osteoarthritis with extra-articular deformities results in less intraoperative blood loss, more precise reconstruction of lower limb alignment, and better early effectiveness. However, long-term effectiveness require further investigation.
目的: 评估无影像机器人辅助人工全膝关节置换术（total knee arthroplasty，TKA）与传统TKA治疗膝骨关节炎合并关节外畸形的早期临床疗效。.
方法: 回顾分析2019年6月—2024年1月收治且符合选择标准的30例膝骨关节炎合并关节外畸形患者临床资料。其中15例行CORI无影像机器人导航辅助关节内截骨TKA（机器人组），15例行传统关节内截骨TKA（传统组）。两组患者年龄、性别、身体质量指数、患膝侧别、关节外畸形角度、畸形位置、畸形类型及术前膝关节活动度、美国膝关节协会评分（KSS）膝关节评分及KSS功能评分、下肢力线偏移等基线资料比较差异均无统计学意义（ P>0.05）。记录并比较两组患者手术时间、术中失血量及并发症发生情况；术前及术后6个月，记录患者膝关节活动度、下肢力线偏移，采用KSS膝关节评分和功能评分评价患者术后膝关节功能。.
结果: 两组手术时间比较差异无统计学意义（ P>0.05）；机器人组术中失血量少于传统组，差异有统计学意义（ P<0.05）。两组患者均获随访，随访时间6～12个月，平均8.7个月。患者切口均愈合良好，未发生血栓形成、感染等术后并发症。术后6个月X线片检查示，两组患者假体位置良好，均未出现假体松动或脱位等表现。两组膝关节活动度、下肢力线偏移及KSS膝关节和功能评分均较术前显著改善，差异有统计学意义（ P<0.05）；机器人组下肢力线偏移和KSS功能评分手术前后变化值均优于传统组，差异有统计学意义（ P<0.05），其余指标手术前后变化值两组间比较差异均无统计学意义（ P>0.05）。.
结论: 与传统TKA相比，无影像机器人辅助TKA治疗伴有关节外畸形的膝骨关节炎患者，术中失血量更少，下肢力线重建更精准，早期临床疗效更佳，但远期临床疗效有待进一步研究。.
Keywords: Navigation-free robot; extra-articular deformities; knee osteoarthritis; lower limb alignment; total knee arthroplasty.